Community-based Animal Health Workers Research Articles

Enhancing Veterinary Services for Smallholder Farmers in Zimbabwe: A Comprehensive Literature Review

In Zimbabwe, the smallholder farming sector holds over 90% of the country's livestock, playing a vital role in the rural economy. However, low productivity and livestock offtake persist due to various challenges, primarily stemming from animal diseases. This literature review examines veterinary services provision in the smallholder sector, focusing on the Zimbabwean context. Through a desktop review of published literature, the study investigates the evolution of veterinary services for smallholder farmers, the key actors involved, and their interactions. It also explores the challenges faced by farmers in accessing veterinary services and identify the gaps in and scope of service provision with a view to identifying ways of improving service delivery. The study showed that the arrangements for provision of veterinary services to the smallholder farmers in Zimbabwe was inadequate. The findings highlight the critical need for an integrated approach to service delivery, involving state veterinary services, the private sector, and community-based animal health workers. The paper concludes by offering recommendations on specific roles of each service provider within an integrated system to enhance service provision in the smallholder sector. This research contributes to the understanding of effective veterinary services and their role in supporting agricultural growth in Zimbabwe.

Livestock for Livelihoods: Role of Goats in Improving the Livelihood and Well-being of Women Pastoralists in Ethiopia and Uganda

Abstract Farm Africa worked with semi-nomadic pastoralist women living in the South Omo region of Ethiopia and Karamoja subregion in Uganda, thereby supporting them to set up sustainable, small-scale goat-rearing enterprises that contributed to increased household income, improved dietary diversity and nutritional status of their families. The project also supported community-based animal health service delivery as part of the integrated approach. Livestock is the main source of livelihood for the pastoralist communities in East Africa, though disease, drought and degraded grasslands make it unproductive. Rural women in pastoralist communities in Ethiopia and Uganda lack nutritional knowledge, financial skills, credit access and a voice in household decision making, which result in them having a low economic status and which contribute to malnutrition. Declining animal health services, due in part to reduced government capacity, exacerbate the challenge of increasing goat productivity. Farm Africa through the Livestock for Livelihoods project (March 2019–July 2021) supported 10,000 women to improve their socio-economic status and improve household nutrition. It supported women beneficiaries to be more economically empowered through access to finance provided by Village Savings and Loans Associations (VSLAs) and facilitated them to be involved in profitable enterprises in the goat value chain (goat breeding, leather tanning and milk value addition). These activities stimulated livelihood diversification and trade, contributing to reduced levels of poverty and malnutrition. Some of the remarkable results include increased revenue that women acquired from the sale of live goats, meat, hides, skins and milk; improved dietary diversity in children under 5 years and women; and increased Women’s Economic Empowerment (WEE) scores. This project created and strengthened a network of Community-Based Animal Health Workers (CAHWs) linked to agro-input dealers to enhance pastoralists’ access to quality animal health services. A total of 155 CAHWs (127 men and 28 women) in the two countries were empowered to provide animal health services to the pastoralists across the project area. The logo of Farm Africa. Information © The Author 2023

Camel health management and pastoralists\u2019 knowledge and information on zoonoses and food safety risks in Isiolo County, Kenya

Camel health management has implications for public health and camel product trade. After liberalization of the veterinary service, current camel health management in the arid and semi-arid lands (ASALS) of Kenya and its implications for public health is not known. This study investigated camel health management and its implications on zoonoses and food safety in Isiolo County, Kenya. Semi-structured questionnaires were administered to 150 households, 15 agro-veterinary shops, 15 community-based animal health workers (CBAHWs) and 10 veterinary officers to collect information on camel health management. The main occupation and source of household income for the pastoral communities is camel-keeping (45.3%). Pastoralists self-medicate camels and other livestock (45.8%), which can lead to between over-dosing, under-dosing or wrong drug use. The CBAHWs, traditional animal health service providers (TAHSPs), government veterinary officers and private veterinary officers play a minimum role. Private veterinary services have not taken root in the ASALs. The sources of knowledge and information on the veterinary drug to use are experience (57.4%), non-governmental organizations (NGO) (41.1%) or CBAHWs (32.1%). The majority of pastoralists (72.5%) do not keep camel or other livestock treatment records. The constraints in purchasing veterinary drugs are expensive drugs, accessibility to drugs and availability of money. Pastoralists refer to veterinary drugs by their brand names but not by active ingredients. As reported by pastoralists, focus group discussion and key informant interviews, antibiotics used were adamycine (33.3%), ampicilline (26.7%), penicillin (14.4%), tetracycline (12.2%), amoxylin (11.1%) and penstrip (2.2%). The common camel diseases were trypanosomiasis, brucellosis, mastitis, diarrhoea, worm infestation, camel pox and tuberculosis. The public health risk factors were the presence of veterinary drug residues in camel products and development of resistant zoonotic organisms/diseases. It was concluded that current camel health management has serious implications for public health and food safety, and hence the camel product trade.

THE PROVISION OF VETERINARY SERVICES: WHO ARE THE INFLUENTIAL ACTORS AND WHAT ARE THE GOVERNANCE CHALLENGES? A CASE STUDY OF UGANDA

SUMMARYAs a result of continued fiscal challenges from the late 1980s to date, the government of Uganda liberalized and decentralized the provision of veterinary services. As a result, many actors are involved in providing veterinary services without adequate regulation and supervision. With the resurgence of infectious diseases, and increased economic and health risks, especially to the rural poor, there is the need to understand relational patterns of actors to ensure good governance, and address emerging and re-emerging risks of animal diseases. A participatory mapping tool called Process Net-Map was used to identify relevant actors and assess their influence in the delivery of clinical and preventive veterinary services in both pastoral and intensive livestock production systems. The tool also served to elicit governance challenges in veterinary service delivery. The results reveal that important social relations in veterinary service delivery include the following: (1) Cooperation between private veterinarians and paraprofessionals as well as private veterinarians and government veterinarians in intensive production systems; and (2) cooperation between NGOs, government veterinarians and community-based animal health workers in pastoral areas. Staff absenteeism, insufficient and unpredictable budgets, weak legislation, exclusion of technical staff from the decision-making process and policy illogicality were identified as major governance problems of veterinary service delivery. The paper concludes that given the existing fiscal challenges, the key to improving animal service delivery in Uganda is getting priorities, policies and institutions right.

Factors influencing the demand of the service of community based animal health care in Zimbabwe

This study was done to find out about animal health service providers and factors that determined demand for community based veterinary service delivery in smallholder sector of Zimbabwe. Focus group discussions and a questionnaire was used to collect data on veterinary services providers and socio-economic factors related to animal health from a sample (N=333) smallholder livestock farmers from Gutu district of Masvingo province in Zimbabwe. Analytical techniques used were descriptive statistics, K-mean cluster analysis and Tobit regression model. Results showed that the majority of farmers (45%) obtained services from both Community Based Animal Health Workers (CBAHWs) and Department of Veterinary Service (DVS), 25% DVS only, 20% used CBAHWs while 10% did not seek any services. Further analysis showed that distance to CBAHW, distance to AHMC and employment status were significantly related to demand for CBAHWs with coefficients of −1.5, 0.7 and −10.3, respectively. The study thus concluded that CBAHW is an alternative animal health service delivery approach already practiced in smallholder farming sectors of Zimbabwe. Socio-economic factors significantly influenced the demand for CBAHW services. Given limited resources by state sponsored veterinary services, it is recommended that the CBAHWs approach should be encouraged as supplementary service provider especially in areas further DVS. These community organizations can be empowered by the state to deliver more improved services based on hygiene and modern science at a relatively low cost to farmers.

Animal Health Management perspectives of rural livestock farmers in Southwest Nigeria: The place of community based Animal Health Workers

A case study of a typical community based rural livestock production system in South-west Nigeria was undertaken using participatory epizootiology (PE) to understand local preferences for animal health management practices and observe if there is any justification or place for community based animal health workers (CBAHW ) in rural livestock health and production management. Sheep and goats were the major animals kept by 46.7% of the respondents, followed by chicken (29.3%), dogs (13.3%), ducks (8.0%) and pigs (2.7%). The major health and production problems identified were Pestes des petit ruminants (PPR) (30.0% of respondents), mange (23.0%) and crop destruction (20.0%); while cannibalism by hawks/eagle was the major problem of poultry production as highlighted by rural women (15%). While more respondents (42.7%) rate modern animal health practitioners as more effective than Fulani pastoralists healers (33.67%) and indigenous local healers (25.0%), modern animal health practitioners were described as least truthful/ unreliable (91.7%), less available (91.7%), most expensive (66.7%) and inaccessible (25.0%). On the other hand, indigenous local healers were rated as very available and more accessible (66.7%) while Fulani pastoralist healers were rated as more available and ready to provide veterinary services (58.3%) compared to indigenous local healers (33.3%) and modern animal health practitioners (8.3%). These results are similar to those obtained in other African countries. In conclusion, despite the prevailing professional apathy to the CBAHW concept by influential veterinary authorities in Nigeria, health issues highlighted by the community-based rural livestock farmers could be adequately addressed by CBAHW.

Veterinary paraprofessionals and community animal health workers in Tanzania

To address the economic hardships of the 1980‟s, Tanzania under pressure from its development partners both bilateral and multilateral embarked on structural adjustment program. In the case of veterinary services delivery systems reforms were advocated founded on privatisation and liberalisation. The government abruptly withdrew from providing clinical services, retrenched a substantial number of paraprofessionals and their training sponsorship was withdrawn. The gap created has not been bridged by the private sector which to date is limited to a few major urbanised foci. Rural producers have been the mostly affected by these reforms. The response has been to try and create a new cadre in the delivery of veterinary services and a reduced emphasis on the role of paraprofessionals. The roles of this new cadre commonly referred to as the community based animal health workers (CAHWs) and paraprofessionals are reviewed. We conclude that before any new cadre is introduced in the delivery system, technical and socio-economic sustainability issues should be researched. Furthermore we advocate that the role of paraprofessionals in the private sector and rural areas should be re-examined. Keywords : CAHW, Tanzania, paraprofessionals, animal health services Tanzania Vet Journal Vol. 25 (2) 2008: pp. 121-131

Utilización de agentes zoosanitarios comunitarios para reforzar los sistemas de vigilancia de enfermedades en Tanzania

An 18 month trial was conducted in three districts of Arusha region, northern Tanzania, to assess the use of community-based animal health workers (CAHWs) in an official disease surveillance system. Disease reports provided by CAHWs were assessed using six indicators for effective disease surveillance, i.e. sensitivity, specificity, timeliness, representativeness, simplicity and acceptability. To assess sustainability issues and determine the incentives required by CAHWs to report disease, three different incentive models were tested in the trial. None of the incentive models involved direct payments to CAHWs. Before involving CAHWs in disease surveillance in the three trial districts, disease case reports as a proportion of cattle population were 0.13%, 0.20% and 0.12%. During the trial, disease case reports as a proportion of cattle population increased to 5.0%, 5.6% and 6.3%. The CAHWs also improved the spatial and temporal coverage of the disease surveillance system and provided timely reports. During the trial, national-level disease reporting in Tanzania increased by 17% owing to the sensitisation and support activities of the Pan African Programme for the Control of Epizootics in Tanzania. In Arusha region, disease reporting increased by 118%, and 49% of this improvement was attributable to increased reporting in the three trial districts. Reporting from these districts far exceeded that from any other district in Tanzania. Veterinarians confirmed the CAHWs' clinical diagnosis in 88% of the 170 clinical cases examined. The increase in disease reporting resulting from CAHW activities was sufficient to enable the national epidemiology unit to achieve its target in relation to World Organisation for Animal Health (OIE) guidelines. The authors conclude that the use of CAHWs should be promoted in the national strategy for disease reporting. Additionally, CAHWs must be brought under the control of the Tanzanian veterinary authorities, a process that will include appropriate legislative reform.

Assessment of the Technical Competence and Ethical Behaviour of Community-based Animal Health Workers in Mwingi District, Kenya

This paper describes an assessment of the technical competence and ethical behaviour of Community-based Animal Health Workers (CAHWs) in Mwingi District, Kenya. From 99 trained CAHWs, 40 participated in the study. Using a pre-tested semi-structured questionnaire, direct observation of the relevant veterinary drug kits and participatory discussions, the study team found that the CAHWs knowledge of clinical signs of local livestock diseases and notifiable and zoonotic diseases and their ability to use veterinary drugs correctly and safely were adequate. Marks were awarded to the candidates according to an agreed marking scheme between the CAHWs' trainers and study team members. The results showed that, overall, 36 out of 40 (90%) of the sampled CAHWs passed the tests. The existence of a referral system for CAHWs and refresher trainings helped to ensure that CAHW competence and ethical behaviour were maintained. However, it was also found that some areas of the current curriculum required more detailed input based on field experience. The CAHW system could serve as an alternative animal health care system in areas lacking veterinary services.

Impact Assessment of a Community-based Animal Health Project in Dollo Ado and Dollo Bay Districts, Southern Ethiopia

Participatory methods were used to assess the impact of a community-based animal health worker (CAHW) project in two remote pastoralist districts of Ethiopia. The CAHW project had been operating for 3 years at the time of the assessment. Participatory methods were standardized and repeated with 10 groups of informants in the project area. The assessment showed significant reductions in disease impact for diseases handled by CAHWs compared with diseases not handled by CAHWs. In camels, there was significant reduction (p < 0.001) in the impact of mange, trypanosomosis, helminthosis, anthrax and non-specific respiratory disease. In cattle there was a signficant reduction (p < 0.001) in the impact of blackleg, anthrax and helminthosis. In sheep and goats there was a sign reduction (p < 0.001) in the impact of mange, helminthosis, contagious caprine pleuropneumonia, orf and non-specific diarrhoea. In order of importance, these reductions in disease impact were attributed to (1) increased use of modern veterinary services provided by CAHWs, (2) vaccination campaigns involving CAHWs, (3) good rainfall and availability of grazing and (4) decreased herd mobility. Decreased herd mobility was also associated with negative impact of tick infestation. Community-based animal health workers were considered to be highly accessible, available, affordable and trustworthy relative to other service providers. They were also perceived to be suppliers of a good quality service. Specific types of positive impact attributed to CAHW activities were increases in milk, meat, income and draught power.

Performance of Community-based Animal Health Workers in the Delivery of Livestock Health Services

Since the liberalization of animal health services in Kenya in the early 1990s, community-based animal health workers (CBAHWs) have become an important alternative animal health delivery channel in the country's marginal areas. However, professional veterinary practitioners have questioned the effectiveness of CBAHW programmes in animal health service delivery in Kenya. This is partly due to lack of information about their performance and partly because CBAHW programmes were implemented before the necessary changes in the existing legal, policy and institutional frameworks had been made. This study was designed to provide such information. In this regard, the productivity of livestock herds among farmers who utilized the services of CBAHWs was compared to that of livestock belonging to farmers who utilized the services of professional veterinarians. The annual live births per mature female (birth ratio) and the proportion of young stock to mature females (breeding index) was computed over a period of 3 years in cattle and goat herds under care of CBAHWs and professional veterinarians. The birth ratios in cattle and goats under CBAHWs were not significantly different from those under the care of professional veterinarians (p > 0.05). Furthermore, the breeding index of cattle and goats under the two categories was not statistically different. Besides the CBAHWs providing clinical services, they also created positive externalities through participatory learning enjoyed by neighbouring livestock keepers, who later dispensed with their services. Policy attention is therefore needed to enhance the participation of CBAHWs in animal health service delivery and to appropriately integrate their activities into the existing formal animal health delivery system in Kenya. Interventions that improve the professional development of these workers, with emphasis on areas pertaining to care of young stock, would not only promote the sustainability of CBAHW programmes but would also improve livestock productivity in the country's marginal areas.

Kenya: the development of private services and the role of the Kenya Veterinary Association.

Private veterinary practice has existed in Kenya for more than half a century. Between the early 1930s and the mid-1960s, provision of clinical and advisory services almost entirely involved servicing commercial ranches and dairy farms. The Department of Veterinary Services (VSD) was mainly responsible for providing regulatory services in these areas. Until the mid-1960s, public sector veterinary responsibilities were predominantly associated with the prevention of notifiable diseases outside the commercial farming areas. In a major agrarian reform programme initiated in 1954, Kenya initiated an aggressive campaign promoting the dairy industry in the wetter areas of the country among small-scale farmers. In an effort to encourage dairy development, the VSD decided to provide some services, mainly tick control and subsidised artificial insemination. This support had a great positive impact on the 'smallholder' dairy industry. After the end of the colonial administration in 1963, most private practitioners left the country. A decision was therefore taken to transfer the responsibility of providing services of a 'private goods' nature, such as clinical services, temporarily to the public sector through the VSD. This was accompanied by significant expansion of training and the deployment of both professional veterinarians and para-professionals. By 1988, personnel costs had escalated to over 80% of the recurrent budget, leaving little for operational costs. This necessitated a policy change, which led to decreased government involvement in the delivery of animal health services. The private sector, as expected, responded appropriately to the change in policy. The Kenya Veterinary Association (KVA) launched a privatisation scheme (the Kenya Veterinary Association Privatisation Scheme) in 1994 to provide members with credit to set up private practices. The first phase of the scheme (1994-1996) was rated a success, with 100% loan repayments. The second phase of the project (from 1997) was characterised by a low number of loan applications, which increased the cost of loan administration per unit. There was some defaulting in loan repayments during this phase. While private veterinary practice took root in the high rainfall, intensive farming areas, this was not the case in the arid and semi-arid lands (ASAL), where community-based animal health workers (CAHWs) played a prominent role in providing animal health services. The lack of uniformity in the training of these workers denied them recognition by the Kenya Veterinary Board (KVB). An agreement has now been reached between the KVB, the Director of Veterinary Services and the KVA to discontinue the training of CAHWs and to retain and retrain existing workers for disease surveillance and reporting in ASAL areas. In conclusion, private veterinary practice has been successful in areas of high agricultural potential. Expansion to more marginal areas, however, would require incentives or subsidies.

The effectiveness of community-based animal health workers, for the poor, for communities and for public safety.

The development of community animal health (CAH) is an invaluable tool for addressing a series of challenges, particularly for the policy-maker, whose prime concern is public welfare. This paper examines three of the major challenges which confront governments, particularly the governments of less-developed countries, namely, the collapse of government services, the crucial issue of poverty reduction and the misuse of animal drugs. Although CAH is a potentially powerful tool for approaching all of these problems, the authors argue that CAH can only be fully exploited on a macroscopic level by developing strong institutions to support and regulate such community initiatives. In some countries, developing such institutions depends upon accepting the more fundamental and controversial principle of legalising non-professional animal health service providers who work within the private sector. In Section 1, the authors outline the three principal challenges which face governments, particularly in developing countries, and to which CAH offers a potential solution. Sections 2 to 4 investigate the evidence relating to each of these challenges in turn. Section 5 briefly draws on the lessons that have been generated by field experiences over the years, to propose how governments may develop CAH systems to their best advantage.

INTEGRATING COMMUNITY-BASED ANIMAL HEALTH WORKERS INTO THE FORMAL VETERINARY SERVICE DELIVERY SYSTEM IN KENYA

The community-based animal health workers (CBAHWs) model has been one of the ways utilised in delivery of animal health services following the veterinary service reforms. Government statutory bodies have opposed the establishment of these programs arguing that their approach to animal health delivery does not fit within the existing technical, legal and policy framework. This study gives an account of the nature, characteristics, and activities of CBAHWs and provides information that would guide policy debate regarding their integration into formal health service delivery. It indicates that these programs provide mainly curative health services but the issue of sustainability has continued to dodge most of them. It establishes that, for trainees to continue actively providing services, continued professional development obtained through regular refresher training and entrepreneurship exemplified by proper record keeping are important. It therefore recommends that policy review is needed to address the role of CBAHWs and appropriately integrate their activities within the formal animal health delivery system.